A speculum includes upper and lower members and a linear support member. The upper member includes an upper blade. The lower member includes a lower blade and a handle portion. The lower blade includes a support structure at a proximal end thereof which extends vertically on the right or left side of the lower blade, and a handle portion extending downwardly from the lower blade and defining a vertical track. The linear support member has a proximal end pivotally connected to the upper blade, a distal end, and an elongated body between the proximal and distal ends. The elongated body slidably engages the vertical track of the handle portion. The linear support member is formed with a hidden slot which slidably receives the support structure of the lower blade.
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1. A speculum comprising:
an upper member comprising an upper blade which has a distal end and a proximal end;
a lower member comprising:
a lower blade having a distal end and a proximal end and having a right side and a left side when viewed from the proximal end of the lower blade, the lower blade comprising a first support structure positioned on a first side of the right and left sides of the proximal end of the lower blade, and
a handle portion connected to the proximal end of the lower blade and defining a vertical track on a second side of the right and left sides of the proximal end of said lower blade, said second side being opposite said first side, such that the lower blade and the handle portion are each asymmetrical when viewed from the proximal end of the lower blade; and
a linear support member having a proximal end pivotally connected to the proximal end of the upper blade, a distal end, and an elongated body between the proximal end and the distal end of the linear support member, the linear support member comprising a first slot disposed on said first side thereon so as to correspond to the first support structure, wherein the first slot comprises a base and two opposite sidewalls, a lateral direction across the proximal end and the distal end of the lower blade substantially traverses the opposite sidewalls, and the first support structure rides within the first slot and is restrained between the opposite sidewalls of the first slot,
wherein the elongated body of the linear support member slidably engages the vertical track of the handle portion.
2. A speculum comprising:
an upper member comprising an upper blade which has a distal end and a proximal end;
a lower member comprising:
a lower blade having a distal end and a proximal end and having a right side and a left side when viewed from the proximal end of the lower blade, the lower blade comprising a first support structure positioned on a first side of the right and left sides of the proximal end of the lower blade, and
a handle portion connected to the proximal end of the lower blade and defining a vertical track on a second side of the right and left sides of the proximal end of said lower blade, said second side being opposite said first side, such that the lower blade and the handle portion are each asymmetrical when viewed from the proximal end of the lower blade;
a linear support member having a proximal end pivotally connected to the proximal end of the upper blade, a distal end, and an elongated body between the proximal end and the distal end of the linear support member, the linear support member comprising a first slot disposed on said first side thereon so as to correspond to the first support structure, wherein the first slot comprises a base and two opposite sidewalls, a lateral direction across the proximal end and the distal end of the lower blade substantially traverses the opposite sidewalls, and the first support structure rides within the first slot and is restrained between the opposite sidewalls of the first slot,
wherein the elongated body of the linear support member slidably engages the vertical track of the handle portion;
a light source; and
a light guide disposed on the lower member for transferring light from the light source to a working space between the upper blade and the lower blade, wherein the light guide has a groove therein, and the groove has an open side closed by the lower member to form a smoke vacuum channel.
4. The speculum of
wherein the proximal end of the linear support member is formed with a pair of holes which pivotally and respectively receive the support beams of the hinge assembly.
5. The speculum of
6. The speculum of
7. The speculum of
8. The speculum of
9. The speculum of
11. The speculum of
12. The speculum of
13. The speculum of
14. The speculum of
15. The speculum of
16. The speculum of
17. The speculum of
18. The speculum of
19. The speculum of
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This application claims priority to U.S. Provisional Application No. 61/387,038 that was filed on Sep. 28, 2010. The entire content of this provisional application is hereby incorporated herein by reference.
The embodiments disclosed herein relate to speculums, and more particularly to disposable vaginal speculums having lateral support and operating mechanisms.
A speculum is a medical instrument for dilating the opening of a body cavity for medical examination. A vaginal speculum commonly used during a gynecological examination or a surgical procedure is introduced into a patient's vagina to separate the vaginal walls, thus allowing the internal genital organs to be examined. Metal, autoclavable specula are conventionally used for gynecological examination and treatment. These units, with exposed joints, sharp edges, and cold metal are universally disliked by patients. The hinged joints and blade edges often pinch, scrape, or otherwise traumatize the supporting tissues in the area being examined. The conventional metallic specula blades are typically opaque. Therefore, the only area available for inspection when a metallic speculum is in use is the open end, for cervical examination, and the vaginal wall areas between the blades.
In an attempt to eliminate some of the problems mentioned above, plastic specula have been developed. Plastic specula, which are formed from plastic or another lightweight and inexpensive material, are often designed with a double-hinge. Although these double-hinge designs satisfactorily support the vertical stresses placed on the speculum, current designs allow for significant movement when exposed to lateral forces. Such lateral forces are common when vaginal muscles become tense during procedures which do not require anesthesia, and the resulting lateral movement is objectional to the physician because it can result in speculum movement inside the vagina, or in the worst case speculum collapse.
Sufficient lighting of the subject area for examination is another area of difficulty, since typical specula are not equipped with illumination devices. Light must be directed from another source, often a gooseneck lamp that can partially obstruct the view into the vagina. Head-mounted lights have been used as a partial solution to this problem, but such head-mounted lights are uncomfortable for the operator and cumbersome due to the light cord. Lights built into the handle of existing specula generally project into a light pipe which follows up the center of the speculum. Since this light and light pipe assembly occupy the center of the handle the speculum hinge mechanism must be offset to one side. However, such offsetting from the center of the speculum has the undesirable effect of increasing lateral movement resulting from stress.
Accordingly, at least one exemplary embodiment may provide a speculum. The speculum according to this embodiment may comprise an upper member, a lower member, and a linear support member. The upper member comprises an upper blade which has a distal end and a proximal end. The lower member comprises a tower blade having a distal end and a proximal end and having a right side and a left side when viewed from the proximal end of the lower blade, the lower blade comprising a support structure positioned at the proximal end of the tower blade and which extends vertically on one of the right side or the left side of the lower blade. The lower member further comprises a handle portion extending downwardly from the proximal end of the lower blade and defining a vertical track. The linear support member has a proximal end pivotally connected to the proximal end of the upper blade, a distal end, and an elongated body between the proximal end and the distal end of the linear support member. The elongated body of the linear support member slidably engages the vertical track of the handle portion. The linear support member is formed with a hidden slot which slidably receives the support structure of the lower blade.
In another exemplary embodiment, a method for dilating a vagina may be provided. The method according to this embodiment may comprise providing a disposable vaginal speculum. The disposable vaginal speculum comprises an upper member, a lower member, and a linear support member. The upper member comprises an upper blade which has a distal end and a proximal end. The lower member comprises a lower blade having a distal end and a proximal end and having a right side and a left side when viewed from the proximal end of the lower blade, the lower blade comprising a support structure positioned at the proximal end of the lower blade and which extends vertically on one of the right side or the left side of the lower blade. The lower member further comprises a handle portion extending downwardly from the proximal end of the lower blade and defining a vertical track. The linear support member has a proximal end pivotally connected to the proximal end of the upper blade, a distal end, and an elongated body between the proximal end and the distal end of the linear support member. The elongated body of the linear support member slidably engages the vertical track of the handle portion. The linear support member is formed with a hidden slot which slidably receives the support structure of the lower blade. The method for dilating a vagina according to this embodiment may further comprise inserting the upper blade and the lower blade of the speculum into an opening of the vagina, and creating a working space between the upper blade and the lower blade, thus dilating the vagina.
The presently disclosed embodiments will be further explained with reference to the attached drawings, wherein like structures are referred to by like numerals throughout the several views. The drawings shown are not necessarily to scale, with emphasis instead generally being placed upon illustrating the principles of the presently disclosed embodiments.
While the above-identified drawings set forth presently disclosed embodiments, other embodiments are also contemplated, as noted in the discussion. This disclosure presents illustrative embodiments by way of representation and not limitation. Numerous other modifications and embodiments can be devised by those skilled in the art which fall within the scope and spirit of the principles of the presently disclosed embodiments.
Vaginal speculums having lateral stabilized support and operating mechanisms are disclosed herein. The disclosed vaginal speculums are fabricated from plastic materials, and are designed to be for single-use and are fully disposable. Although the vaginal speculums disclosed herein are intended to be used by gynecologists, it is understood that the vaginal speculums may also be used for example, by primary care physicians, geriatricians, urologists and nurse practitioners.
As used herein, the term “cross-contamination” refers to the passing of bacteria or viruses indirectly from one patient to another through the use of improper sterilization procedures, unclean instruments, or recycling of products.
As used herein, the term “disposable” refers to a vaginal speculum of the present disclosure designed for short-term convenience, and intended for single-use. The disposable vaginal speculum therefore does not need to be sterilized after use, which reduces the cost of maintaining the vaginal speculum, and minimizes the risk of cross-contamination.
As used herein, the term “female internal genital organs” refers to the vulva, vagina and cervix.
As used herein, the term “gynecological examination” or “surgical procedure” refers to a medical procedure performed on a female patient to visualize, inspect, and/or remove a portion of the female internal genital organs. Common gynecological procedures and surgeries include, but are not limited to, colposcopy, cervical cryosurgery, loop electrosurgical excision procedure (LEEP) procedure, hysteroscopy, dilation and curettage (D&C), cervical biopsy, transcervical chorionic villus sampling, endometrial ablation, endometrial biopsy, vaginal hysterectomy and PAP test.
The vaginal speculums disclosed herein can be used during various medical procedures, and more particularly are used for unecological procedures either in an office or a hospital setting.
As used herein, the term “elevational movement” refers to the vertical up-and-down movement of an upper blade relative to a lower blade of a vaginal speculum of the present disclosure.
As used herein, the term “linear” refers to a straight line of material, for example, a straight line of plastic material. A linear support member refers to a support member of the present disclosure that is made from a straight line of plastic material, having no curves or angles.
As used herein, the term “angulational movement” refers to the angular up-and-down movement of an upper blade relative to a lower blade of a vaginal speculum of the present disclosure.
As used herein, the term “lateral movement” refers to the sideways back and forth movement of an upper blade relative to a lower blade of a vaginal speculum of the present disclosure.
As used herein, the term “open state” refers to the positioning of an upper blade and a lower blade of a vaginal speculum of the present disclosure at a spaced-apart distance. The open state may be accomplished by elevating a support member that connects the upper blade and the lower blade together, by angularly moving the upper blade relative to the lower blade, or by a combination of both.
As used herein, the term “working space” refers to a space created between an upper blade and a lower blade of a speculum of the present disclosure. In an embodiment, the working space is created for viewing, examining, and performing surgical procedures on female internal genital organs.
As used herein, the term “structural integrity” refers to a feature provided by a vaginal speculum of the present disclosure prior to, during, and after use. An upper blade and a lower blade of the speculum are designed to withstand applied loads and transfer these applied loads to various other components of the speculum, while maintaining the structural integrity of the speculum.
As used herein, the term “fulcrum” refers to a support structure created by engaging a support member and a support structure of a vaginal speculum of the present disclosure. The created fulcrum results in the ability for an upper blade of the vaginal speculum to angularly move with relation to a lower blade of the vaginal speculum.
As shown in
As best illustrated in
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As shown in the embodiment depicted in
During a gynecological examination or surgical procedure, it is sometimes desirable to illuminate the working area so that a medical professional performing the procedure can properly view the working area. Typical specula are not equipped with illumination devices, and newer speculums that contain light sources generally generate unwanted heat, consume significant power, are tethered to a power source, and project light in unwanted directions. The power consumed requires wires to an external power supply which is cumbersome for a medical practitioner, creates a potential hazard to a patient, and is a source of cross-contamination, as the light source is not easily sterilized between procedures. The unwanted directionality of light will not only illuminate the practitioners working space, but also will illuminate the practitioner and impair the practitioner's vision.
Attempts to overcome the above shortcomings have been problematic themselves. One known speculum includes a fiber bundle built into the speculum and an external light source. While this overcomes the heat generation and light directionality problem, the problem for cross-contamination still exists. Another known speculum discloses a light bulb built into the speculum handle with a reflector also built into the handle. While this overcomes the problem of light directionality, problems related to cross-contamination and heat generation still exist. Other speculums disclose a battery operated halogen light source built into the handle. This solves the cross-contamination problem, but does not solve the light directionality problem and heat problem.
In an embodiment, the LED light source 164 is a white LED.
In an embodiment, single or multiple wavelength LED sources can be substituted to choose a light wavelength that is uniquely suited to materials, chemicals, tissue, or tools used in current or future gynecological procedures such that these materials, chemicals, tissue or tools will distinctly illuminate when such wavelengths are projected, thus aiding in the practitioner's ability to view and perform a procedure, aiding in material property changes (such as epoxy hardening or activating some other specific material property), altering the state of tissue life, or serving as a contamination neutralizing agent.
In an embodiment, the LED light source 164 is a single wavelength light emitting diode.
In an embodiment, the LED light source 164 is a multiple wavelength light emitting diode.
In certain gynecological procedures, it is desirable to remove abnormal cells from the internal and external portions of the cervix. Also, certain gynecological procedures use instruments that produce smoke, which makes it difficult for a medical professional to see a working space during the procedure. Therefore, the use of an external vacuum source during gynecological procedures is common. These external vacuum sources are cumbersome, difficult to manipulate during the procedure, and are a source of cross-contamination, since the vacuum is re-used for many patients.
Existing specula containing both a light guide and a smoke evacuation channel have typically built the light guide into the lower blade thereof and the smoke evacuation channel into the upper blade thereof. This arrangement significantly detracts from the working space between the two blades that is needed to perform vaginal or uterine procedures. Additionally, an external suction tube must be connected to the upper blade of these existing specula which further complicates and obstructs the working area for the physician.
In an embodiment, debris is drawn from the distal end 138b of the light guide 138 through the channel 138c that extends under the light guide 138 and out the bottom of the speculum handle 134 where external suction tubing can be attached.
In an embodiment, bodily fluids are drawn from the distal end 138b of the light guide 138 through the channel 138c that extends under the light guide and out the bottom of the speculum handle 134 where external suction tubing can be attached.
The ability of the speculum 100 of the present disclosure to withstand applied loads is a result of a combination of components of the speculum 100, including, but not limited to, the geometry of the hinge assembly 125, a support beam 128, the parallel support beams 129, the geometry of the upper blade 122 and the lower blade 132, the lateral support structure 136 and the hidden slot 191, and the interdependent loading between the various components. In an embodiment, during use, pressure exerted on the operating mechanism 127 is transferred to the hinge assembly 125, the mechanical holes 153, and down the elongated body 154 of the linear support member 150. As shown clearly in
During use of the speculum 100, for example during a gynecological procedure, the speculum 100 is inserted into a patient's vagina. The vaginal walls in turn exert a pressure, or load, on the upper blade 122 and the lower blade 132 of the speculum 100. The upper blade 122 and the lower blade 132 are capable of transferring this load to the support member 150 and the operating mechanism 127 because of the unique design of the lateral support structure 136 of the lower member 130 of the speculum 100. The support structure 136 is capable of supporting the lateral load and distributes the vertical load equally down both the linear support member 150 and the operating mechanism 127. This results in a great deal of holding power in a relatively small area without lateral top blade movement or top blade hinge failure.
The upper blade 122 and the lower blade 132 have a curved shape which increases the stiffness and strength of the blades. The stiffness imparted on the curved blades enables the blades to support the applied load along an entire length of the blades, without the need for additional strengthening structures within the blades. The proximal end 152 of the linear support member 150 and the parallel hidden slot 191 and track 137 help prevent failure of the speculum 100 due to asymmetric loading on the blades that would cause the speculum 100 to twist relative to the handle's 134 axis. The design of the speculum 100 prevents twisting.
To operate the speculum 100 of the present disclosure during a gynecological procedure, the upper blade 122 and the lower blade 132 are inserted into a vagina of a patient in a closed position. Closed position can refer to complete closure, where the upper blade 122 engages the lower blade 132, or can refer to partial closure, where the upper blade 122 and the lower blade 132 are partially separated. Thereupon, the linear support member 150 is moved upwardly by pressing on the elevation leg 155 until a desired degree of opening has been attained. The locking tooth 159 of the elevation leg 155 locks with the stop tabs 131 on the outer surface of the handle 134. In an embodiment, when the desired degree of opening has been attained, the operating arm 127 of the operating mechanism 125 is pressed spreading the upper blade 122 and the lower blade 132 apart at an angle. The locking teeth on the angulation arm 157 lock at the opening 126 of the operating mechanism 125, resulting in the speculum 100 being held in the open position. The light source 160 may be turned on to illuminate a surgical or examination site. The pull tab 165 of the light source 160 is removed, resulting in the LED 164 illuminating. At the end of the procedure, the pull tab 165 may be inserted again to turn the LED 16 off. It is to be understood that a speculum 100 of the present disclosure may be fabricated in various sizes, such that the proper sized speculum 100 can be used for each patient. The speculum 100 may also be fabricated from various strength plastic materials based on the desired use of the speculum 100, as long as the structural integrity of the speculum 100 remains. For example, for a routine PAP test, a lower strength speculum 100 may be used as compared to a speculum 100 for use during vaginal hysterectomy.
In an embodiment, a speculum 100 is provided that includes an adjustable upper blade 122 and an adjustable lower blade 132 capable of expanding during use of the speculum 100. Means for providing adjustable blades include, but are not limited to, the use of laterally adjusting blades that expand the width of the blades and the use of longitudinally adjustable blades that expand the length of the blades. The adjustable blades can be withdrawn partially or completely.
In an embodiment, a speculum 100 is provided that includes heating means for warming the upper blade 122 or the lower blade 132. The extra warmth provided by the heating means enhances patient comfort and helps to relax the vaginal area. Means for heating the blades include, but are not limited to, the use of heating coils within a hollowed out space of the blades, the use of powdered chemicals within a hollowed out space of the blades that are able to oxidize when exposed to air. In an embodiment, a speculum 100 includes heating coils on the upper blade 122 and the lower blade 132 for bringing the temperature of the blades to body temperature. In an embodiment, the heating coils can be powered by the batteries 166 used in the built-in light source 160. In an embodiment, the heating coils can be powered by a different battery.
In an embodiment, a speculum 100 is provided that includes a distally mounted camera chip for real-time data capture and/or viewing of a medical procedure. The camera chip can store and/or capture data, and communicate with computer software to analyze the data. Data captured on the camera chip can be analyzed for cellular and visual abnormalities of the vulva, vagina and cervix.
In an embodiment, a speculum 100 is provided that includes a pressure gauge, so that the pressure being applied from the speculum 100 to the vagina, or from the vagina to the speculum 100, can be monitored, as well as the tightness of the vaginal canal. The pressure gauge may be similar to a strain gauge and may be built into the speculum 100, for example, at the hinge assembly 125.
In an embodiment, a speculum 100 is provided that includes a pH test strip or a pH meter, for the fast and accurate determination of the acidity level of the vaginal canal being examined. The pH strip or pH meter would be exposed to vaginal secretions to access the pH at any point in a gynecological or surgical procedure.
In an embodiment, a speculum 100 is provided that includes means for lubricating either or both of the upper blade 122 and the lower blade 132. The lubricated blades make it easy for the speculum 100 to be inserted into a vaginal cavity of a patient, while providing a moist work environment during a gynecological or surgical procedure.
In an embodiment, a body of the upper blade 122 and/or the lower blade 132 has a hollowed-out space for passage of a lubricating jelly, as well as holes at a surface for release of the lubricating jelly.
In an embodiment, the speculum 100 may come pre-packaged with an amount of lubricating jelly within the hollowed-out space of the blade. The lubricating jelly is released through the holes present at the blades surface, for example, by pushing a button on the handle 134. In an embodiment, the speculum 100 may include a port that can attach to a luer-lock syringe having the lubricating jelly, for passage of the lubricating jelly into the blades.
A method for dilating a vagina includes providing a disposable vaginal speculum. The speculum has an upper member containing an upper blade, a lower member containing a lower blade and including one or more lateral support beams that extend downward from an interior side of the lower blade, and a linear support member that connects the upper member having the upper blade to the lower member containing the lower blade, such that the linear support member engages the lateral support beam or beams and engages a rotational operating mechanism extending off the upper blade and a linear operating mechanism extending from the lower member. The linear support member is vertically moveable within a track positioned at a single side of a handle portion of the lower member. The method for dilating a vagina further includes inserting the upper blade and the lower blade of the speculum into an opening of the vagina, and creating a working space between the upper blade and the lower blade, thus dilating the vagina.
All patents, patent applications, and published references cited herein are hereby incorporated by reference in their entirety. It will be appreciated that several of the above-disclosed and other features and functions, or alternatives thereof, may be desirably combined into many other different systems or applications. Various presently unforeseen or unanticipated alternatives, modifications, variations, or improvements therein may be subsequently made by those skilled in the art which are also intended to be encompassed by the following claims.
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